Indan Journal of Medical Research Indan Journal of Medical Research Indan Journal of Medical Research Indan Journal of Medical Research
  Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login  
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 328       
SYSTEMATIC REVIEW
Year : 2018  |  Volume : 148  |  Issue : 4  |  Page : 385-395

Persistent febrile illnesses in Nepal: A systematic review


1 Department of Medicine, B.P. Koirala Institute of Health Science, Dharan, Nepal; Epidemiology and Control of Neglected Tropical Diseases Unit, Institute of Tropical Medicine, Antwerp, Belgium; Institute of Global Health, University of Geneva, Geneva, Switzerland
2 Institute of Global Health, University of Geneva; Division of Tropical & Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
3 Epidemiology and Control of Neglected Tropical Diseases Unit, Institute of Tropical Medicine, Antwerp, Belgium
4 Department of Medicine, B.P. Koirala Institute of Health Science, Dharan, Nepal

Correspondence Address:
Dr Marleen Boelaert
Epidemiology & Disease Control Unit, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp
Belgium
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_505_18

Rights and Permissions

Background & objectives: Although febrile illnesses are a frequent cause of consultation and hospitalization in low- and middle-income countries (LMICs), research has mainly focused on acute febrile illnesses (AFIs). In contrast, there are limited data on the causes of persistent febrile illnesses (PFIs) in LMIC. Lack of clarity on the differential diagnosis of PFIs in the rural tropics leads to the absence of diagnostic guidance tools. Methods: In this study, a review of the potential causes of persistent fever defined as fever of more than seven days was done in Nepal, with a focus on nine pathogen-specific conditions. The current knowledge on their burden, distribution and diagnosis was summarized. Results: Limited data were found on the incidence and public health burden of leptospirosis, murine typhus and brucellosis due to the absence of diagnostic tools outside reference laboratories and the overlap of signs and symptoms with other febrile conditions. The incidence of malaria and visceral leishmaniasis (VL) was found to be decreasing in Nepal, with some changes of the geographical areas at risk. Interpretation & conclusions: This review indicates a need for more research on the causes of PFIs in Nepal and in the region and for the development of clinical guidance tailored to current local epidemiology. Guidance tools should include specific clinical features (e.g. eschar), results of rapid diagnostic tests (e.g. malaria, VL), appropriate indications for more sophisticated tests (e.g. abdominal ultrasound, polymerase chain reaction) and recommendations for adequate use of empirical treatment.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed907    
    Printed4    
    Emailed0    
    PDF Downloaded212    
    Comments [Add]    
    Cited by others 1    

Recommend this journal